Queries raised by parents about cleft deformities:

Q. What are the causes of cleft lip or palate?
A. Genetics and environmental factors are both considered instrumental in causing clefts. Cleft parents are known to be predisposed to having cleft children. But the main cause is attributed to the deficiency of Folic Acid during pregnancy. The other causes are radiation, pollution, nutritional deficiency, psychologically disturbed pregnant women, trauma, alcohol consumption, smoking, tobacco chewing during pregnancy. The development of cleft is not influenced by simple x- rays, medications taken under medical supervision, trivial illness, injuries etc.

Q. Is there a possibility of giving birth to another cleft child?
A. Yes. There is a high chance, if there is a genetic predisposition related to the familial history. Had the etiology been an environmental cause, there is a fair chance that the next child may be a normal one.

Q. Is a cleft lip always associated with cleft palate? A. Cleft lip is not always associated with cleft palate.

Q. What can be done for my child born with a cleft?
A. Surgical repair of the cleft can be successfully done restoring appearance and function to normal. Most of the babies born with cleft have nasal deformity, so along with cleft surgery, nose correction is also done. We have seen excellent results in our patients. The treatment should begin as early as possible.

Q. Why do cleft lip and palate require many surgeries? Is it not enough to do once?
A. Depending upon the deformity, surgeries are performed. The surgeon plans the surgeries with the ultimate aim of achieving normal form and function. The functional treatment always precedes the esthetic correction and has to be constantly revised as the child grows.

Q. Will my child look normal after surgery?
A. Not immediately after surgery because of the swelling in the lip region and the scar appears red. The scar takes about 6 - 12 months to disappear to give a pleasing look.

Q. How many days should my child be in the hospital after surgery?
A. The child is hospitalized for maximum of 2 - 3 days.

Q. Can parents stay along with the child in the hospital?
A. Parents can stay and take care of the child in the hospital. The details about the stay can be cleared from the hospital staffs.

Q. How should I feed my child before surgery?
A. If the child’s lip is incompletely split and the palate is intact, breast feeding or nursing bottle can be used. Regarding feeding please ask the doctor in charge as the child is always placed under 6 hour fasting prior to surgery.

Q. How will my child feel about having cleft?
A. Insecurity in infants is due to parents’ depression, child’s lethargy and irritability. Social support, self-confidence and motivation might prove advantageous. So parents should have frank discussion and counseling about cleft management and should give their children proper guidance and encouragement.

Q. Whom should I ask concerning the cleft?
A. Team of specialists, under Prof. Balaji work together for the rehabilitation of children with cleft and can be contacted at Balaji Dental and Craniofacial Hospital.

Q. Will my child speak like a normal child?
A. A child can speak well after the surgical repair of the cleft. Children with difficulty should undergo speech therapy and improvement in the speech depends on the co-operation and encouragement shown to the child.

Q. How the palate helps in speech?
A. Before the palate is repaired, there is no separation between the nasal cavity (nose) and the mouth. This means that the child cannot build up air pressure in the mouth because air escapes out of the nose. The roof of the mouth has very less tissue for the tongue to touch. These problems can make it difficult for the child to talk.
Once the palate has been repaired, your child may be able to learn more words and speech can be improved with training and encouragement.

Q. Will the nasal twang and fluid that escapes out of the nose stop after the treatment?
A. It cannot be estimated immediately because palatal repair takes time for healing. When the muscles become flexible the air can escape through the nose and mouth equally enabling the child to talk. Hence it is always mandatory to perform the surgery as advised by the Surgeon. Palate surgery should be done before the child learns to speak.